| NPI | 1174212591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN MCNAMARA Authorized Official 949-929-1768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2023-05-02 |
| Last Update Date | 2024-03-03 |